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用于上肢创伤后缺损的带血管骨移植

Vascularized bone grafts for post-traumatic defects in the upper extremity.

作者信息

Petrella Giovanna, Tosi Daniele, Pantaleoni Filippo, Adani Roberto

机构信息

Department of Hand Surgery and Microsurgery, University Hospital Policlinico of Modena, Modena, Italy.

出版信息

Arch Plast Surg. 2021 Jan;48(1):84-90. doi: 10.5999/aps.2020.00969. Epub 2021 Jan 15.

DOI:10.5999/aps.2020.00969
PMID:33503750
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7861969/
Abstract

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

摘要

带血管蒂骨移植（VBGs）被广泛用于重建上肢骨缺损。传统骨移植通常用于治疗小于5 - 6厘米的缺损，此时组织血管化良好且无感染风险。带血管蒂腓骨移植（VFGs）主要用于肱骨、桡骨或尺骨，用于传统骨移植失败的持续性骨不连病例或大于6厘米的骨缺损。此外，VFGs被认为是桡骨、尺骨和肱骨大骨缺损的标准治疗方法，并且能够重建软组织缺损，因为VFGs可以作为骨皮瓣进行切取。VBGs能够进行一期手术重建，并且由于其自身的血管化而具有高度抗感染性。带血管蒂股内侧髁（VFMC）游离皮瓣可用于治疗上肢的小缺损和骨不连。这些手术的相对禁忌证包括糖尿病、免疫抑制、慢性感染、酗酒、吸烟、药物滥用和肥胖。我们研究的目的是阐述VFGs在治疗上肢创伤后大骨缺损和骨髓炎中的应用。此外，还介绍了VFMC自体移植的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d597/7861969/51861482e735/aps-2020-00969f11.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d597/7861969/51861482e735/aps-2020-00969f11.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d597/7861969/8ce3376dc3f0/aps-2020-00969f9.jpg
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